Hip Pelvis.  2013 Sep;25(3):232-236. 10.5371/hp.2013.25.3.232.

Bilateral Insufficiency Fracture of Medial Subtrochanteric Area of the Femur: A Case Report

• Chae DS
• Lee JH
• Lee WS
• Yang IH
• Han CD

• KMID: 1974380
• DOI: http://doi.org/10.5371/hp.2013.25.3.232

Abstract

A non-traumatic, incomplete insufficiency fracture commonly involves the lateral side of the femoral cortex; whereas a non-traumatic, incomplete stress fracture commonly involves the medial side of the femoral cortex. Here, we describe a case of a 66-year-old woman with a two-month history of bilateral thigh pain without trauma or medication usage who was diagnosed with bilateral subtrochanteric insufficiency fractures involving the medial side of the femoral cortex.

Keyword

Femur; Subtrochanteric fracture; Stress fracture

MeSH Terms

Aged
Female
Femur
Fractures, Stress*
Humans
Thigh

Figure

• 

  Fig. 1 (A) AP and (B) lateral plain radiographs of both femurs show no bony abnormalities.

• 

  Fig. 2 Bone scan shows increased uptake in the medial subtrochanteric areas of both femurs.

• 

  Fig. 3 T2-weighted signal intensity (A) coronal and (B, C) axial MR images of both femurs show increased signaling of the medial subtrochanteric area of the marrow. Linear low signal intensities are seen at just below the lesser trochanter in left femur and 2 cm below the lesser trochanter in right femur.

• 

  Fig. 4 After 3 months, (A) AP and (B) lateral plain radiographs of both femurs show no interval change.

Reference

1. Egol KA, Koval KJ, Kummer F, Frankel VH. Stress fractures of the femoral neck. Clin Orthop Relat Res. 1998; (348):72–78.

2. Shane E, Burr D, Ebeling PR, et al. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2010; 25:2267–2294.

3. Lo JC, Huang SY, Lee GA, et al. Clinical correlates of atypical femoral fracture. Bone. 2012; 51:181–184.

4. Blatz DJ. Bilateral femoral and tibial shaft stress fractures in a runner. Am J Sports Med. 1981; 9:322–325.

5. Salminen S, Pihlajamaki H, Avikainen V, Kyrö A, Böstman O. Specific features associated with femoral shaft fractures caused by low-energy trauma. J Trauma. 1997; 43:117–122.

6. Hershman EB, Lombardo J, Bergfeld JA. Femoral shaft stress fractures in athletes. Clin Sports Med. 1990; 9:111–119.

7. Kang L, Belcher D, Hulstyn MJ. Stress fractures of the femoral shaft in women's college lacrosse: a report of seven cases and a review of the literature. Br J Sports Med. 2005; 39:902–906.

8. Boden BP, Speer KP. Femoral stress fractures. Clin Sports Med. 1997; 16:307–317.

9. DeFranco MJ, Recht M, Schils J, Parker RD. Stress fractures of the femur in athletes. Clin Sports Med. 2006; 25:89–103. ix

10. Beck TJ, Ruff CB, Shaffer RA, Betsinger K, Trone DW, Brodine SK. Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors. Bone. 2000; 27:437–444.